Abstract:Manual small incision cataract surgery (MSICS) has widely been used in clinical operation, especially in developing countries. This article aims to compare the efficacy and safety (intraoperative and postoperative complications) among conventional extracapsular cataract extraction (ECCE), MSICS and phacoemulsification. By using the PubMed search engine, we collected the relevant literatures on MSICS, ECCE and phacoemulsification. Meanwhile, the relevant literatures published in Chinese journals were also referred to. Compared with phacoemulsification, both MSICS and ECCE achieved excellent visual outcomes with low complications. MSICS does not depend on expensive instrument, and is significantly faster, less expensive, and requires less technology; therefore, MSICS is especially suitable to hard nucleus cataract surgery. Though MSICS demands skill and patience during cataract surgery, it is a safe, effective and economical treatment and is used as an alternative to phacoemulsification in developing countries.

Abstract:AIM: To investigate the effect of hyaluronidase use on the quality of sub-Tenon's anesthesia for phacoemulsification.METHODS: This was a randomized, double-blind clinical trial which was conducted at Nikookari Eye Hospital for 5 months. Forty-two eyes of candidates for phacoemulsification under sub-Tenon's anesthesia were randomly allocated to two equal groups and received either 2mL of lidocaine 2% solution with (LH), or without (L) addition of hyaluronidase (150U/mL). Akinesia was assessed 15 minutes after sub-Tenon's injection. Patients and surgeon's satisfaction, as well as the postoperative pain (the visual analogue scale, VAS) were investigated after operation. The contingency tables (including the Chi-square or Fisher's exact tests, when appropriate) and parametric analysis (the independent samples ttest) were used for statistical analysis.RESULTS: Complete akinesia (33.3% vs4.8%, P=0.04), as well as the patients (85.7% vs57.1%, P=0.04) and surgeon's satisfaction (87.5% vs52.4%, P=0.02) were significantly more frequent in LH than in L group. The mean VAS was significantly lower in the same group (1.90±1.45 vs3.00±1.55, P=0.04).CONCLUSION: Addition of hyaluronidase to lidocaine solution for sub-Tenon's anesthesia significantly improves the ocular akinesia, enhances the intra-operative patients and surgeons' satisfaction, and attenuates the postoperative pain.

Abstract:AIM: To investigate the expression of Skp2,p27 and PTEN proteins in B-cell non—Hodgkin lymphoma(NHL) of ocular adnexa.METHODS: Paraffin sections were collected from patients suffering from B-cell NHL (n=30) and lymphadenosis (n=10) of ocular adnexa in Qingdao Affiliated Hospital from 1995 to 2011. Features (age, gender, pathogenetic locations, pathological type) can be used as factors to classify 30 cases of B-cell NHL. Lymphadenosis sections were selected to the control group. The expression of Skp2,p27 and PTEN proteins were detected by immunohistochemistry and the positive expression rate between lymphomas and lymphadenosis was compared. Spearman rank correlation was used to estimate the relationships among Skp2, p27 and PTEN in ocular lymphoma. RESULTS: The expression of three proteins were not related to age, gender, pathogenetic locations but related to pathologic type of tumors. In B-cell NHL specimens, the expression of p27^kip1 and PTEN was lower than that in lymphadenosis (P<0.05), while the expression of Skp2 was higher.Skp2 labeling frequency was increased dramatically in plasmacytoma(PL) and diffuse large B-cell lymphoma(DLBCL) compared with mucosa-associated lymphoid tissue(MALT)(P<0.01). While p27^kip1 and PTEN labeling frequency in PL and DLBCL was significantly lower than that of MALT(P<0.05,P<0.01). There was a negative correlation between p27^kip1 and Skp2 in MALT(r=-0.134, x²=12.58,P＜0.05）while there was a positive correlation between p27^kip1 and PTEN（ r=0.828, x²=20.66,P＜0.05）．The relationship between Skp2 and PTEN was also negative(r=-0.883, x²=20.52,P＜0.05).CONCLUSION: Over expression of Skp2 and lower expression of p27^kip1 and PTEN play an important role in the tumorigenesis and different pathologic type in ocular adnexal tumors. The expression of three proteins correlates with each other in MALT. Combined examination of Skp2,p27 and PTEN is a valuable marker to predict the presence of the B-cell NHL of ocular adnexa and differentiate the pathologic type of tumors.

Abstract:AIM: To evaluate relationship between ocular pseudoexfoliation syndrome(PXF) and sensory-neural hearing loss (SNHL). METHODS:This prospective case-control study was designed on patients who referred to a general ophthalmic clinic at Imam Khomeini Medical Center, Urmia, Iran (March 2010 through November 2010). On routine ophthalmic examination, patients diagnosed with ocular PXF were referred to the ENT department and, selected cases (after evaluating inclusion and exclusion criteria) were referred to Audiometric Department. Pure tone hearing threshold level(HTL) was measured at 1, 2, 3 kHz for each ear and was compared with International Standard (ISO 7029) median age associated hearing loss(AAHL) at 1, 2, 3 kHz.RESULTS: Overall 21(42.0%) of 50 patients had a higher HTL than the ISO 7029 median AAHL at 1, 2 and 3kHz, which included 14 ears of 9 patients in the male group and 21 ears of 12 patients in the female group. Approximately 12.0% of patients had glaucoma at the same time, however; no significant correlation was found in SNHL prevalence and severity between PXF patients and patients with simultaneous glaucoma. SNHL was more common in patients with ocular PXF compared to their age- sex matched controls (P<0.05).CONCLUSION:Most of patients with ocular PXF had SNHL compared to their age-sex matched controls, which could be due to PXF fibrils in the inner ear. These findings suggest PXF could be a systemic disease.

Abstract:AIM: To examine the effect of oxybuprocaine hydrochloride (OBPC-HCl) on in vitrocultured human corneal endothelial (HCE) cells and provide foundations for clinical safety use of OBPC-HCl.METHODS: After treated with OBPC-HCl at different concentrations, the growth situation and morphology of in vitrocultured HCE cells were checked under an inverted light microscope, membrane permeability was detected by acridine orange/ethidium bromide (AO/EB) double-fluorescent staining. DNA fragmentations and ultrastructure of HCE cells were observed by DNA agarose gel electrophoresis and transmission electron microscopy (TEM), respectively. RESULTS: In vitrocultured HCE cells treated with OBPC-HCl at a concentration between 62.5mg/L and 4g/L showed typical characteristics of apoptosis, including cell shrinkage, intercellular vacuolation, membrane permeability increasing, chromatin condensation, apoptotic body appearance and DNA fragmentation. The apoptosis-inducing effect of OBPC-HCl was in dose- and time-dependent manners. The greatest apoptosis-inducing effect of OBPC-HCl on HCE cells was found at the clinic concentration of 4g/L, and the apoptotic rate of HCE cells reached 100% after treated for 1 hour. CONCLUSION: OBPC-HCl at a concentration of 62.5mg/L-4g/L has an obvious apoptosis-inducing effect on HCE cells, and has huge toxic side effects on HCE cells during its clinic ophthalmic usage.

Abstract:AIM:To test the difference of protein composition in tear between cornea transplantation immunological rejection rats and rats with no rejection by SELDI protein chip technology, and to find cornea transplantation immunological rejection associated protein and deduce the possible mechanisms of cornea transplantation immunological rejection.METHODS: To build homogeneity penetrability corneal transplantation rat model: The grafts of group Ⅰ came from side-center and the suture tail remained about 1mm while grafts of group Ⅱ came from center cornea and the suture remained as short as possible. Slit-lamp microscopy was used to observe the three indexes of cornea score in opacity, edema and new vessels from the 1^st day after operation. The result data were as mean±SD and tested by independent-sample ttest in SPSS 13.0 software. The difference was set at P＜0.05. The tears were collected at the 7^th. Capture marker with WCX2 protein chip. Then find out the protein combination that can best distinguish the two group samples. Preliminary screening the marked proteins in Swiss-Prot and TrEMBL protein library.RESULTS: The 7^th day post-operation was sample collection time. It is the time to distinguish the graft rejection group from non-rejection group. 108 proteins were marked in total in two groups, there are 11 kinds of proteins with classified value, among these 6 kinds got high classify value. The result of albumin search library result suggested that the related albumin maybe Neuropeptide Y, β-defensin 1,Glucagon,and Cortistatin-14.CONCLUSION:It is reliable to obtain proteomic profiles in tear for rat marker of cornea graft rejection using SELDI-TOF-MS with well reproducibility. The results suggest that neuripeptide and energy maybe play an important role in graft rejection.

Abstract:AIM: To investigate the effect of low-concentration intermittent oxygen inhalation on diabetic rats' hemorheology and retinal leakage. METHODS: Healthy and clean male SD rats were randomly divided into three groups: control group, diabetes group, diabetes treated with oxygen inhalation group. The rats in the diabetesgroup and the diabetes treated with oxygen inhalation group were intraperitoneally injected streptozotocin (STZ). The rats in the control group were intraperitoneally injected citrate buffer. The rats in the diabetes treated with oxygen inhalation group inhaled 300mL/L oxygen for 2 hours daily. Two months after modeling, the rats' hemorheological parameters were measured with blood rheometer. The rats' retinal Evans leakage was quantitatively measured and the integrity of the blood ocular barrier was analyzed using Evans blue as a tracer.RESULTS: The high shear viscosity of whole blood, middle shear viscosity of whole blood, low-shear viscosity of whole blood, relative index of high shear, relative index of low shear, high-shear reduced viscosity, low shear reduced viscosity, haematocrit, erythrocyte aggregation index, plasma viscosity, Casson viscosity and K value of erythrocyte sedimentation rate equation of diabetes group were higher than those of control group and diabetes treated with oxygen inhalation group. The differences among three groups were statistically significant (all P<0.05). The plasma viscosity and the Casson viscosity of diabetes treated with oxygen inhalation group were similar to those of control group. The differences were not statistically significant (both P>0.05). The high shear viscosity of whole blood, middle shear viscosity of whole blood, low-shear viscosity of whole blood, relative index of high shear, relative index of low shear, high-shear reduced viscosity, low shear reduced viscosity, haematocrit, erythrocyte aggregation index and erythrocyte rigidity index of diabetes treated with oxygen inhalation group were lower than those of control group and diabetes group. The differences among three groups were statistically significant (all P<0.05).The retinal Evans leakage of diabetes group was higher than that of control group and diabetes treated with oxygen inhalation group. The retinal Evans leakage of diabetes treated with oxygen inhalation group was higher than that of control group, while was lower than that of diabetes group. The differences among three groups were statistically significant (P<0.05).CONCLUSION: Low-concentration intermittent oxygen inhalation can reduce diabetic rats' blood viscosity, increase diabeticrats' retinal blood supply and oxygen supply, and reduce diabetic rats' retinal leakage.

Abstract:AIM: To investigate the earlier period pathology changes after high air pressure wave traumatic injury in cultured retinal Müller cell.

METHODS: A model of high air pressure wave traumatic injury in cultured retinal Müller cell was established, the expression of glial fibrillary acidic protein(GFAP)after cell injury was tested by immunochemistry. The change of lactate dehydrogenase(LDH)activity and cell apoptosis rate after cell injury were observed. RESULTS: Increased expression of GFAP changes was observed 3 hours after injury. Then it maintained high level of expression within 24 hours, the results were related with injury degree(P<0.05). LDH release increased within 30 minutes after injury. The apoptosis rate had non-significant difference within 30 minutes after injury(P>0.05). The percentage of apoptotic cells increased 3 hours after injury and reached the highest 6 hours after injury.

CONCLUSION: The changes of Müller cell shape and the permeability of cell membrane maybe one of factors to trigger the increasing expression of GFAP.

Abstract:AIM: To investigate how vascular endothelium growth factor (VEGF) contributes to the expression of pigment epithelium-derived factor (PEDF) in retina of rats and evaluate the neuroprotection of VEGF for retinal ganglion cells (RGCs) of rats with chronic intraocular hypertesion and it''s potential approach. METHODS: Thirty female adult Sprague Dawley rats were randomly divided into three groups: elevated intraocular pressure (EIOP) + VEGF ( group A, including A3d, A14d),EIOP +placebo (group B, including B3d, B14d), normal + VEGF (group C, including C3d, C14d). The model of EIOP were established by obstructing episcleral veins in group A and B, only open the bulber conjunctiva without obstructing episcleral veins in group C. In group A and C, shortly after episcleral veins were cauterized, rats were intravitreously injected 2μL VEGF (concentration: 0.05μg/μL) at 2.0mm behind the limbus of cornea. To keep the IOP, 2μL vitreous body were drawn out before the intravitreous injection. In group B, 2μL H₂O were intravitreously injected. Three days and 14 days later, the animals were sacrificed and the eye balls were cut with cryostat, then TUNEL staining protocol were carried out to detect apoptotic cells and degenerate neurons in the retina. Immunofluorescent double labeling was performed to identify which cells were PEDF-positive cells in the retina.RESULTS:The IOP was obviously increased after the operation(P＜0.05), there was no significant difference in IOP between 3 days and 14 days after the operation. TUNEL-positive cells and FJ-positive cells in retina of chronic intraocular hypertension group were much more than that of normal group. The number of TUNEL-positive cells in retinas of chronic intraocular hypertension+ VEGF group was reducing. CONCLUSION: Intravitreal administration of VEGF has the effect of reducing the apoptosis of the RGCs in rats with chronic intraocular hypertension. 

Abstract:AIM: To investigate the effect of heparanase (HPA-1) inhibitor on the proliferation of human retinal pigment epithelial (RPE) cell. METHODS:Hunan RPE cells were primarily cultured and the fifth generation cells were used in the experiment. The phosphomannopentaose sulfate(PI-88) solutions of different concentrations were added into the medium for 48 and 72 hours to co-culture the cells. The proliferation of human RPE cell was estimated using MTT colorimetric assay as the A₅₇₀ value. The expression of keratin and HPA-1 in the cells was detected by immunochemistry.RESULTS: HPA-1 was intently expressed in both the cytoplasm and nucleus of human RPE cells, and weak expression was seen in RPE cells co-cultured with PI-88. Either in 48 hours or 72 hours, the A₅₇₀ values of various concentrations of PI-88 culture group were significantly declined in comparison with without PI-88. When PI-88 was administered for 72 hours, the A570 values showed the tendency of reduction to those of 48 hours in >100mg/L groups.CONCLUSION:HPA-1 inhibitor can suppress the proliferation of human RPE cell at the concentration- and time-dependent manner in vitro.

Abstract:AIM: To study the inhibition of Tripterygium Polyglucoside on chemical burn induced model of corneal neovascularization (CNV). METHODS: A model of CNV was created by 750mL/L silver nitrate solution burn in 20 healthy rats which were subsequently randomized into two groups: the control group underwent normal saline eye drops, and the experimental group underwent Tripterygium Polyglucoside eye drops. After the chemical burns, the area of CNV was recorded and photographed, and the histology of cornea was evaluated under light microscopy. RESULTS: Fourteen and 28 days after creation of the model,the area of CNV in control group were 35.4±3.5mm² and 52.5±6.2mm², respectively; the area of CNV in experimental group was 30.0±2.7mm² and 41.0±5.6mm², respectively. There was significant difference between the two groups (P＜0.05). No obvious toxic effects of Tripterygium Polyglucoside eye drops to the corneal tissue were observed under the microscopy analysis. CONCLUSION: CNV can be significantly suppressed by the topical use of Tripterygium Polyglucoside eye drops.

Abstract:AIM: To investigate the expression of matrix metalloproteinase-9(MMP-9) and nuclear factor of κB (NF-κB) in retinoblastoma (RB) and their relationships with differentiation and optic never infiltration for discussion their effect in invasion and metastasis of RB.METHODS:Immunohistochemical technique was adopted to examine the protein expression of MMP-9 and NF-κB in 47 cases. All the data were analyzed by statistics. RESULTS:The expression ratio of MMP-9 was 46.8%, and the expression was also significantly related to the differentiation degree(P<0.05) and never infiltration(P<005). The positive rate of NF-κB expression was 63.8%. The expression had notable relationship with the differentiation degree (P<0.05), but not correlated with the never infiltration (P>0.05). The expression of NF-κB had an obvious relationship with the expression of MMP-9 (P<0.05).CONCLUSION: In RB, MMP-9 expressed in higher level. NF-κB was activated and had higher expression in RB. The expression of NF-κB was related to the expression of MMP-9. The activation of NF-κB can possibly promote invasion and metastasis of RB by up-regulating the expression of MMP-9. Detecting the expression of MMP-9 and NF-κB may be biological indicator of invasion and metastasis of RB and can help to filter cases with high risk of metastasis. 

Abstract:AIM: To investigate the safety and efficacy of active removal of silicon oil with a 23-gauge(23G) transconjunctival sutureless vitrectomy system. METHODS: Clinical records of 58 patients (58 eyes) enrolled in Xiamen Eye Center from February 2011 to June 2011 underwent removal of silicon oil with a 23G transconjunctival sutureless vitrectomy system(30 patients 30 eyes) or with standard 20-gauge(20G) vitrectomy system(28 patients 28 eyes) were reviewed. The mean operation time and silicone oil removal time and the difference between preoperative and postoperative introcular pressure(IOP) levels and best-corrected visual acuity(BCVA) with two kinds system was compared by t-test. Rate of retinal reattachment and complications and postoperative comfort were also compared.RESULTS: The mean operation time was 21.81±5.64 minutes(23G group)versus 35.43±6.42 minutes(20G group),(t=6.382, P<0.01). The mean silicone oil removal time was 6.8±2.76 minutes(23G group) versus 6.4±2.41 minutes(20G group),(t=0.356, P>0.05). The preoperative and postoperative 1 day,1 week, 3 months, 6 months BCVA between the two groups(23G group vs20G group)were 0.35±0.21, 0.23±0.22, 0.26±0.21, 0.38±0.27, 0.45±0.26; 0.36±0.28, 0.10±0.26, 0.24±0.27, 0.37±0.25, 0.41±0.23. A statistically significant improvement in 23G group was found on postoperative day 1 than 20G group (t=1.753, P<0.05). No statistically significant difference were found on preoperative BCVA and postoperative 1 week, 3 months, 6 months(t=0.584, 0.474, 0.583, 0.652, P>0.05). The preoperative IOP and postoperative 1 day, 1 week, 3 months, 6 months between the two groups(23G group vs20G group)were 18.3±2.21, 12.2±2.42, 15.2±231, 16.3±2.97, 16.5±2.23; 17.6±2.28, 11.1±2.47, 16.4±2.37, 16.9±2.27, 17.4±2.26. No statistically significant difference in the preoperative and postoperative IOP between the two groups(P>0.05). A statistically significant decrease in postoperative IOP was found on day 1 in each group (t=1.779, 1.874,P<0.05). No statistically significant difference of postoperative IOP was found on 1 week, 3 months, 6 months was recorded in each group(P>0.05). Silicon oil was completely removed in 20G group. Two patients in 23G group remained a little silicon oil bubbles, and were absorbed postoperative 6 months. Retinal reattachment was achieved in all cases. Postoperative hypotony (<8mmHg) was seen on postoperative day 1 in two groups, 20G group 2 eyes (714%) versus 23G group 4 eyes(13.33%), but all resolved spontaneously within 1 week. No other postoperative complications, such as vitreous hemorrhage, choroidal detachment, endophthalmitis, were noted on examinations during follow-up. Mean number of weeks discomfort of the eye after the operation: 0.85±1.23(23G group)vs2.62±1.23(20G group), (t=5.942, P<0.01). Mean number of weeks the eye looked reddish after the operation: 1.15±1.23(23G group)vs4.13±2.38(20G group),(t=5.753, P<0.01).CONCLUSION:Active removal of silicone oil through a 23G transconjunctival sutureless vitrectomy system is safe and effective.

Abstract:AIM: To evaluate the efficacy and safety of autologous serum(AS) eye drops with 0.01g/L Thiomersal in the treatment of recalcitrant dry eye syndrome. METHODS: Twenty-six eyes of 13 patients with recalcitrant dry eye syndrome were enrolled in this self-control study, and treated with 2 months of AS 20% with 0.01g/L Thiomersal followed by 2 months of AS 50% with 0.01g/L Thiomersal. Tear membrane lever(TML), tear film break-up time (BUT), corneal fluorescein staining(FL), SchirmerⅠ test with topical anaesthesia(SⅠt), corneal sensitivity test and subjective symptom scoring were performed at entry, 2, 4, 8, 12 and 16 weeks. Statistical analysis was carried out using Wilcoxon''s signed rank test. RESULTS: Both TML and subjective symptom scorning showed significant improvement after 2 weeks of treatment (P<0.01,P<0.05); after 4 weeks of treatment, BUT and FL were significant improvement(P<0.05); SⅠt and corneal sensitivity were significant increased after 8 weeks of treatment(P<0.01,P<0.05). No significant complications were reported in this study. CONCLUSION: AS eye drops 20% with 0.01g/L Thiomersal are effective and safe in treating refractory dry eye syndrome, and should be available as an alternative management option in developing countries.

Abstract:AIM: To explore the use of scleral tunnel small incision and manual nuclear chopping in small pupil hard nucleus cataract extraction and foldable intraocular lens(IOL) implantation, and observe the postoperative clinical effects in patients.METHODS:Seventy cases 70 eyes underwent small pupil hard nucleus cataract extraction using a 5.5mm scleral tunnel in anti-superciliary arch posterior to corneal limbus, then they were implanted the foldable or PMMA IOL. The postoperative visual acuity, astigmatism degree as well as complications were observed.RESULTS:Of the 70 cases 70 eyes, 47 eyes(67%) with visual acuity≥0.5, 17 eyes(24%)≥0.8, and 5 eyes(7%)<0.25; the average corneal astigmatism of preoperative, 1 day, 1 week, 1 month was 0.35±0.29,0.42±0.33,0.39±032,0.37±0.30D, respectively. There was no significant difference in corneal astigmatism among the postoperative time points(P≥0.05). Intraoperatively, posterior capsular rupture occurred in 4 eyes(6%), hyphema in 5 eyes(7%), corneal edema in 6 eyes(9%), posterior synechia in 5 eyes(7%), increased tension in 5 eyes(7%) which was resolved after treatment, posterior capsule opacification in 6 eyes(9%) which recovered after treatment.CONCLUSION:The results suggest that the small pupil hard nucleus cataract extraction using scleral tunnel small incision and manual nuclear chopping overcome the drawbacks of long-term limbal incision, minimize the postoperative astigmatism, and improve the success rate of surgery, It requires no special equipment, and it is a simple easy method, it has the same effect as phacoemulsification, and it can effectively reduce the corneal astigmatism, get good vision, and reduce the cost of surgery.

Abstract:AIM: To evaluate long-term visual performance after Tetraflex accommodative intraocular lens(AIOL) implantation by measuring the visual acuity, pseudophakic accommodation, visual symptoms.METHODS: Case-control study. Forty-three consecutive age-related cataract patients (49 eyes) were enrolled and received routine cataract phacoemulsification with IOL implantation surgery. All the cases were randomly divided into 2 groups: Tetraflex group(21 cases 25 eyes), which received Tetraflex AIOL ( and SA60AT group(22 cases 24 eyes), which received Acrysof SA60AT IOL (3, 6, and 24 months postoperatively, the uncorrected and best-corrected distance visual acuity(UCDVA and BCDVA), uncorrected and best distance-corrected near visual acuity(UCNVA and BCNVA), pseudophakic accommodation, diopter and complications were studied between the two groups. Questionnaire of visual function was used to investigate the visual symptoms. The indexes were analyzed by SPSS13.0 statistics software.RESULTS: There were no statistically significant differences in UCDVA and BCDVA between the two groups 3, 6, and 24 months postoperatively (P>0.05); while there were statistically significant differences in UCNVA and BCNVA (P<0.05 ). Minus lens method was applied to evaluate the pseudophakic accommodation: after 3 months, Tetraflex group was 3.56±1.20D, SA60AT group was -0.25±0.20D; after 6 months, Tetraflex group 3.08±1.30D, SA60AT group -0.20±0.18D; 24 months later, Tetraflex group 2.85±1.22D, SA60AT group -0.15±0.16D. Tetraflex AIOL lens provided excellent pseudophakic accommodation than monofocal IOL(P<0.05), and also in close reading and satisfaction of the curative effects (P<005). CONCLUSION: Compared with monofocal IOL, Tetraflex AIOL provides age-related cataract patients with good distance and near vision, as well as pseudophakic accommodation. Although pseudophakic accommodation of Tetraflex AIOL decreases in long-term, it gradually becomes stable.

Abstract:AIM:To evaluate the retinal vascular system in senior hypertensives by pulse pressure (PP) in cataract surgeries. METHODS:Prospective and case control study. Fifty-eight patients (58 eyes) who were scheduled for uniocular phacoemulsification and intraocular lens(IOL) implantation were settled to either group A (hypertensive) or group B (normotensive). PP measurements were recorded on the day they were hospitalized as baseline (PP₁), just before surgeries started (PP₂), during phcaoemulsification (PP₃), before IOL implanted (PP₄), and at the endpoint of the surgeries (PP₅). Data were analyzed by statistical software SPSS 18.0.RESULTS: PP₁-₅ measurements were as follows respectively, 61.92±13.27, 77.39±13.57, 75.18±16.18, 7271±15.94, 72.68±15.75mmHg in group A; and 46.50±11.71, 64.95±14.17, 64.20±13.10, 59.35±12.84, 62.00±1397mmHg in group B. There was significant statistical difference in PP measurements between groups (P>0.05). The increases in PP₂ measurements were 15.47±14.13 and 18.45±13.75mmHg, respectively. And no significant statistical difference was found in the increase of PP₂ measurements (P>0.05). No significant statistical differencewas found in the main effects within groups (F=0.679, P>0.05).CONCLUSION:The high level of PP has important roles in organ damage to senior hypertensives in cataract surgery. And further study may be needed to establish the effect of the transient instability of PP on visual function.

Abstract:AIM:To investigate the relationship between anthropometric parameters and diabetic retinopathy (DR) in adults with diabetes. METHODS: A hospital-based study was conducted. All patients underwent detailed eye examinations by using slit-lamp lens photographs, and fundus photographs of both eyes were taken from a retinal camera, fundus photographs were graded for DR. Cases (n=326) were confirmed with DR with 40-75 years old, and controls (n=326) were admitted to same hospital for different diseases not related with gynecologic ocular diseases. Cases and controls were matched with 1∶1. Using a structured interviewer-administrated questionnaire that included information on sociodemographic characteristics, lifestyle habits, detailed medical history, simultaneously, all subjects were interviewed, and height, weight, waist circumference(WC) and hip circumference of the subjects were measured. Then, body mass index (BMI) and waist-to-hipratio (WHR) were calculated. The odds ratios (OR) and 95% confidence intervals (CI) of DR for anthropometric measurements were estimated with unconditional multiple logistic regression models. RESULTS: For men, compared with controls, the results of weigh, BMI, and WHR were statistically significant (P<0.05). The findings of WC and hip circumference were highly significant (P<0.05). Adjusted for age, sex, Greater BMI was not significantly associated with DR. WC >80cm was related with DR (OR=2.017, 95%CI: 1.393-2.920, P=0.000). For WHR >0.88, the risk of DR significantly increased (OR=2.041, 95%CI: 1.422-2.929, P=0.001). After adjustment for multiple potential confounders, BMI 18.50-23.99kg/m² was negative associated with DR (OR=0.427, 95%CI: 0.231-0.791, P= 0.007). Similarly, It was showed increased DR risk with increasing WHR and WC (OR =1.729, 95%CI: 1.163-2.572, P=0.007; OR=1.991, 95%CI: 1.353-2.931, P=0.001, respectively). CONCLUSION: Obesity, especially abdominal obesity or central obesity, has potential clinical implications in the management of DR. Thus, diabetes and DR should be effectively prevented through keeping WC and WHR. 

Abstract:AIM:To observe the clinical effect of microperimetry-1 (MP-1) combined microperimetry in detection of early diagnosis in acute retrobulbar neuritis.METHODS: Standard W-WP and MP-1 were used respectively on the physical examination of normal youth in 20 cases (40 eyes), 45 cases of acute retrobulbar neuritis (62 eyes) testing. RESULTS: The difference of mean sensitivity(MS) of the MP-1 detection between the two groups was 10.3 ± 1.10dB, and mean defect(MD) of visual field ofMP-1 detection; between the two groups was -2.5±3.23dB, which was with significant statistically differenct (P<0.01); the detection sensitivity of MP-1 on visual function damage in acute retrobulbar was higher than standard W-WP, specific to 90%, sensitive 92%. CONCLUSION: MP-1 has an intuitive basis of unique objective retinal anatomy and subjective quantitative highly sensitive of visual pinpoint of visual function damage than standard W-WP it has unique effect in early clinical diagnosis, treatment and follow-up of acute retrobulbar neuritis, shows that.

Abstract:AIM: To analyze the therapeutic effects and clinical characteristics of free-flap epipolis laser in situkeratomileusis (Epi-LASIK). METHODS: In this prospective case-series study, 27 eyes of 27 myopic and myopic astigmatism patients underwent Epi-LASIK with free-flap as group A and the other 27 eyes underwent standard Epi-LASIK as group B. Symptoms, slit-lamp examination, uncorrected visual acuity(UCVA), spherical equivalent refractive error, intraocular pressure, haze were observed in these patients in 6-month follow-up period. RESULTS: Pain grade: Group A 1 to 3, with an average of 2.2; Group B 1 to 3, with an average of 2.3. Eye sensation duration: 1 to 3 days in group A, an average of 2.2 days; Group B 1 to 3 days, an average of 2.9 days. Epithelial healing time: group A was 3 to 6 days, an average of 4.4 days; 5 to 7 days in Group B, with an average of 5.8 days. Compared with the preoperative best- corrected visual acuity (BCVA), after six months, 1 (4.0%) eye in each group was with UCVA lower than one line, and the remaining 52 (96.0%) were at or higher than the preoperative BCVA. No BCVA declined. Diopter (spherical degree) group A -0.5D- +0.75D equivalent, an average of 0.28±0.27D; group B -0.25D - +0.68D, with an average 0.23±0.26D. Haze grading less than or equal to 05 in 19 (70.4%) eyes in group A, grade 1 in eight (29.6%); group B was with less than or equal to grade 0.5 in 18(66.7%), grade 1 in nine (33.3%) . There were no haze grade higher than or equal to 2.CONCLUSION: Both the free-flap Epi-LASIK and the ordinary Epi-LASIK have safety, predictive and refractive stability, but the free-flap Epi-LASIK surgery significantly shortened the time of stimulating symptoms and improve the recovery of visual acuity.

Abstract:It is an important task of correcting refractive error bycontact lenses in the optometry field. Contact lenses include orthokeratology lens, rigid gas permeable contact lens and soft contact lens. This article gives a general review on the safety and effectiveness of correcting the ametropia by contact lens.

Abstract:Neovascular glaucoma(NVG) is a kind of refractory glaucoma which due to kinds of abnormal ocular and extraocular factors which would cause hypomia of eyeball. Early diagnosis and effective treatment are critical in controlling the intraocular pressure(IOP) and maintaining better visual acuity. Whereas the pathological mechanisms and effective treatments are uncertain. We made this review on the pathological mechanisms of NVG upon recent papers.

Abstract:Refractory glaucoma has complicated causes and lower successful rate in routine filter rating surgery with obvious ocular tissue structure destruction. The major cause of failure is occlusion in filter rating canal by fibroblast proliferation and scar. This article reviews the method, effect and complications of improved surgical treatments reported both at home and abroad.

Abstract:Glaucoma is a common clinical blinding eye disease, currently surgery is the principal way, but the recurrence rate after surgery is still high, the main reason is fibroblasts in the operation area, which lead to scar formation blocking filtration road. To improve the success rate of surgery, a number of anti-cicatricial drugs are increasingly being applied in glaucoma filtration surgery in experimental and clinical studies, but these drugs also have certain complications and side effects. As medical technology advances, people are looking for some safer and more effective drug delivery methods and new drugs that inhibit scar formation.

Abstract:Recurrent retinal detachment is a rather difficult complication after retinal detachment surgery. In order to handle it properly, we need to understand its recurrence factors, and take the appropriate treatment according to its etiology. We retrospectively reviewed the recent years related literatures on the causes and treatment of recurrent retinal detachment both at home and abroad. 

Abstract:Retrobulbar neutitis(RN), caused by many factors, is a common clinical eye disease, generally it can be divided into acute and chronic types, the latter type is more common. Acute RN has fast onset, short duration, and sharp decline in vision, even to no light perception, for some patients, it could even develop into chronic RN. Timely and effective treatment should be given so as to avoid and reduce the late irreversible optic damage. Now we made a review on the current domestic and foreign research situation of RN in order to make a closer understanding of its etiology, pathogenesis and treatment progress, and provide help for the clinical treatment.

Abstract:Capsular contraction syndrome(CCS) after cataract surgery is a rare complication with the equator of the capsular bag diameter is narrow which often results in glare, diplopia, ametropia, visual disturbance and affects the postoperative effects. With the popularity of extracapsular cataract extraction surgery, more patients take phacoemulsification in cataract surgery. Nowadays CCS absorbs more people''s attention. Preventing the syndrome''s occurrence and Nd:YAG laser treatment can improve the visual effects of the patients. This article reviewed the clinical features, etiology, prevention and treatment status of CCS.

Abstract:AIM:To study the correlation of the axial length(AL), diopter(D), keratometric power (K₁,K₂) and central corneal thickness(CCT) of high myopia.METHODS :Eighty cases(158 eyes ) were divided into 3 groups depending on their diopters: 26 cases(46 eyes) with diopters arranged from -6.00D--9.00D in group A (myopia group); 57 cases(97 eyes) with diopters arranged from -9.25D--20.00D in group B (high myopia group); 9 cases(15 eyes) with diopters over 20.25D in group C (super high myopia group). AL, diopter, keratometric power and CCT of three groups were measured. RESULTS: There were significant difference(P<0.05) among AL values of three groups (group A: 26.75±015mm; group B: 29.25±0.19 mm; group C: 32.27±0.84mm). Positive correlations existed between AL values and diopters of three groups （r=0.352,0.715,0.622;P<0.05）,while negative correlations between AL values and K₁、K ₂（r₁=-0.630,-0.494,-0.750, r₂=-0.609,-0.465,-0.782;P<0.05）. Positive correlations existed between diopters and K₁,K₂ in group A, while did not exist in group B and C. No correlation existed between CCT and diopters of three groups.CONCLUSION: Axial growth was the main influence factor of high myopia, keratometric power was the second factor, and CCT has no influence.

Abstract:AIM:To observe themorphological features of corneal endothelial cells in acute episode of anterior uveitis, and to explore the damage mechanism of corneal endothelial by fresh keratic precipitates (KP). METHODS:Fifty cases(50 eyes) with acute anterior uveitis of first time onset were selected in this study. Inflammation lasted for 3 days or more, KP≥(+++) as acute attack group (group A). Inflammation receded completely, KP(-) as group B. The opposite eye with no onset of acute anterior uveitis as group C. All people were measured by non-contact corneal specular microscopy, which included cell density(CD), hexagonality(HG), average size(AVG), standard deviation of the average cell area(SD), the variation coefficient of the cells in the area(CV), and the central corneal thickness(CCT) was measured. Then the data were compared and analyzed.RESULTS:Compared with group C, CD and HG of group A reduced, AVG, SD, CV, CCT of group A increased, the difference were statistically significant(P<0.05). Compared with group C, HG of group B reduced, CV increased, the difference was statistically significant(P<0.05). Compared with group B, HG of group A reduced, CCT and CV increased, which had statistical significance(P<0.05). Comparison among three groups showed that CV and HG had statistical significane（P＜0.05）.CONCLUSION:Fresh KP of acute anterior uveitis can increase the corneal thickness, change the form of endothelial cells and also reduce their function. After the alleviation of inflammation, corneal thickness tends to normal, but changing patterns of cells persisted.

Abstract:AIM:To investigate the effect of phacoemulsification and intraocular lens ( IOL) implantation in treatment of high myopia.METHODS:Phacoemulsification and IOL implantation was performed in 45 cases (52 eyes) with high myopia cataract.RESULTS:The postoperative visual acuity of 43 eyes(83%) improved differently, the visual acuities were>0.4 in 12 eyes(23% ),0.1-0.4 in 33 eyes (63% ),<0.1 in 7 eyes (13% ). The visual acuities have no change in 9 eyes (17% ).CONCLUSION: Phacoemulsification and IOL implantation is a safe and effective method for treating high myopia and correcting refractive error.

Abstract:AIM:To investigate the clinical effect of silicone oil removal combined with manual small incision extracapsular cataract extraction and intraocular lens (IOL) implantation. METHODS:Fifty-six cases (56 eyes) of complicated cataract induced by silicone oil-filled eye underwent silicone oil removal combined with manual small incision extracapsular cataract extraction and intraocular lens implantation. Postoperative follow-up ranged from 3 to 12 months with medium 7.26±1.38 months. Data were collected on corrected visual acuity, intraocular pressure (IOP), reaction of anterior chamber, location of IOL, opacity of posterior capsular, vitreous hemorrhage and reattachment of retina. RESULTS:Postoperative visual acuities of 53 eyes (95%) increased, ≥0.05 in 47 eyes（84%）, ≥0.3 in 27 eyes（48%）, there was significant difference between preoperative and postoperative vision (P＜0.05). Four eyes (7%) had temporary ocular hypertension and recovered by local drugs. Posterior capsulectomy was performed with the Neodymiun: YAG laser in 15 eyes (27%), retinal detachment happened in 2 eyes (4%). None of the cases had complications, such as bullous keratopathy,silicone oil residues, IOL displacement and vitreous hemorrhage. CONCLUSION:Silicone oil removal combined with manual small incision extracapsular cataract extraction and intraocular lens (IOL) implantation is a safe and effective method for complicated cataract induced by silicone oil-filled eye, it can improve vision, shorten period of surgery and reduce times of surgery.

Abstract:AIM:To research the long-term curative effectiveness and safety of compound trabeculectomy for primary open angle glaucoma(POAG) with intraocular pressure elevation after non-penetrating trabeculectomy. METHODS:Thirteen cases (25 eyes) who underwent compound trabeculectomy for (POAG) with intraocular pressure(IOP) elevation after non-penetrating trabeculectomy treated in our hospital during March 2006 to July 2011 were retrospectively analyzed. Glaucoma with high IOP after operation belonged to refractory glaucoma. Compound trabeculectomy was used to treat glaucoma eyes with central island and tubular vision under topical anesthesia combined tenon anesthesia. Those factors were taken into account such as IOP, visual acuity, cornea, filtering bleb, anterior chamber depth and complications.RESULTS:All patients were followed up for 3 months to 5 years. The IOP was 28-52mmHg before the operation, and 11.7-18mmHg postoperatively. At the last visit 3 months after operation the IOP was 14.5mmHg. We set the IOP ≤21mmHg for success criteria. Three months later, vision was improved in 3 eyes (12%) , unchanged in 17 eyes (68%), declined in 5 eyes (20%), and in 25 eyes (100%) , cornea became transparent .There were 22 eyes (80%) with functional filtering blebs. The other 3 eyes with IOP elevation and non-function filtering blebs were also cured by compound trabeculectomy. The incidence of shallow anterior chamber, hyphema, and aqueous flare was 60%, 40%, 20%, and those signs disappeared after treatment. There was no occurring of complication such as endophthalmitis.CONCLUSION:Compound trabeculectomy is the further development of trabeculectomy, which is the most classic and effective way for glaucoma. Compound trabeculectomy for the treatment of POAG with ocular hypertension was found to have a long term curative effectiveness and safety. Compound trabeculectomy, as a supplementary means of ocular hypertension after non-penetrating trabecular operation, effectively protect the remaining vision. But advanced POAG is not suitable for non-penetrating trabeculectomy. 

Abstract:AIM:To analyze the clinical effects of the argon laser photocoagulation for the treatment of retinal vein occlusion(RVO) .METHODS:Totally 57 cases with RVO treated by argon laser photocoagulation were followed up. Observe patients'' visual acuity, fundus change, complications and evaluate the clinical value of argon laser photocoagulation in treating RVO. Laser therapy were divided into macular grid photocoagulation, local and pan-retinal photocoagulation according to the fundus fluorescein angiography(FFA).RESULTS:After laser treatment, visual acuity of 23 eyes improved, 25 eyes had no change, 9 eyes declined. FFA was checked after laser treatment(observing the area changes of retinal capillary in non-perfusion area, as well as the regression of neovascularization), 54 eyes were effective, 3 eyes occurred neovascular glaucoma(NVG). Laser photocoagulation had no significant effect to late complications in macular area.CONCLUSION:Laser photocoagulation can improve central visual acuity, promote the absorption of retinal edema, hemorrhage and exudation, reduce neo vessels caused by RVO, which has significant effect on preventing and delaying proliferative vitreoretinopathy(PVR) and secondary NVG.

Abstract:AIM:To study the levels of serum stromal cell-derived factor-1β(SDF-1β) and leptin in patients with type 2 diabetes mellitus (T2DM).METHODS:Twenty-eight cases with T2DM were divided into two groups, diabetic retinopathy (DR, 14 cases), and no diabetic retinopathy (NDR, 14 cases). A total of 14 healthy subjects were enrolled as normal control group(NC). The levels of serum SDF-1β and leptin were measured by Enzyme-linked Immune sorbent Assay(ELISA). RESULTS:The levels of serum SDF-1β and leptin were decreased by degrees from NC to NDR, DR groups. Compared with NC group, level of SDF-1β was lower (P=0.011). There was positive correlation between the level of SDF-1β and leptin (r=0.524, P<0.001).CONCLUSION:The levels of serum SDF-1β in T2DM patients with DR are decreased and they likely contribute to diabetic complications such as diabetic retinopathy by passing into peripheral organization. Further studye is necessary to the role of Leptin.

Abstract:AIM：To investigate the expression and relationship of Survivin and Fas in primary pterygium. METHODS:SP immunohistochemistry was used to detect the expression of Survivin protein and Fas protein in primary pterygium of 40 cases and nomal conjunctiva of 20 cases. All data were analyzed by SPSS 11.5.RESULTS:The positive expression of Survivin in pterygium (37.5％) was higher than that in normal conjunctiva tissues(10.0％, P＜0.05). The positive expression of Fas in primary pterygium was significantly higher (75.0％)than that in normal conjunctiva tissues (15.0％, P＜0.05). There was a positive correlation between the expression rate of Survivin and Fas in primary pterygium(P＜0.01) and there was consistency between the expression strength of Survivin and Fas in primary pterygium（P＞0.05）. CONCLUSION：It indicated that Survivin may play an important role in the pathway of development of primary pterygium. There was a close correlation between the expression of Survivin and Fas in primary pterygium. It also indicated that Survivin and Fas may commonly participate in the occurrence and development of primary pterygium. 

Abstract:AIM: To investigate the clinical features of congenital nasolacrimal duct obstruction and affecting factors of the outcome of lacrimal probing.METHODS:We retrospectively analyzed 616 infants (687 eyes) with congenital nasolacrimal duct obstruction who underwent lacrimal probing in the Department of Ophthalmology of Shenzhen Children's Hospital between June 2010 and May 2011. The main study items include the following: age at the initial consulting, age at the time of lacrimal probing, gender, mode of delivery, purulent secretion, past history of lacrimal rinsing, past history of lacrimal probing. We sumed up the clinical features and investigated the possible relationship between the above clinical parameters and success rate of lacrimal probing. The criterion for success of lacrimal probing is defined as: disappearance of epiphora and purulent secretion, and patency confirmed by lacrimal rinsing.RESULTS:There was no significant difference on the success rate of lacrimal probing between natural birth and Cesarean birth (P=0.376). The success rate of lacrimal probing between male and female infants also showed no significant difference (P=0.498). The success rate of lacrimal probing is negatively associated with the age at the time of lacrimal probing (P=0.001). The success rate of lacrimal probing at 3, 6, 9, 12 and 15 months was 100%,97.8%,90.8%,83.3% and 76.5% respectively (P=0.018). The success rate of lacrimal probing in infants with purulent secretion was significantly decreased (P=0.013). Past history of lacrimal rinsing did not influence the success rate of lacrimal probing (P=0.561). However, infants with past history of lacrimal probing showed significantly reduced success rate of lacrimal probing as compared with those without past history of lacrimal probing (P=0.042).CONCLUSION:The success rate of lacrimal probing for congenital nasolacrimal duct obstruction decreased significantly with the increasing age. Purulent secretion was also risk factor for the failure of lacrimal probing. It is important to effectively control local inflammation and perform lacrimal probing as earlier in order to increase the success rate of lacrimal probing for infants with congenital nasolacrimal duct obstruction.

Abstract:AIM:To discuss the clinical effects of congenital nasolacrimal duct obstruction(CNLDO) in different stages with conservative treatment and lacrimal passage probing. METHODS:Thirty-seven infants (41 eyes), aged 20 days to 2 months, diagnosed with CNLDO were followed in the study between 2008 and 2011. Conservative dacryocyst massage was performed on infants ＜6 months. Lacrimal passage probing was performed on infants ＞6 months when conservative treatment had no effect. RESULTS:All infants finished follow-up,25 eyes(61.0%) were cured within six months after birth. The rest of 16 eyes(39.0%) received lacrimal passage probing after six months, of which 14 eyes resolved after the first probing and 2 eyes resolved after the second probing. CONCLUSION:Conservative treatment before 6 months in CNLDO was recommended. After 6 months, lacrimal passage probing could help promote the effect. 

Abstract:AIM:To explore the relationship of intraocular pressure (IOP), central corneal thickness(CCT),refraction dioptres and corneal curvature before LASIK.METHODS: Totally 220 cases (440 eyes) with refractive errors were enrolled and the data were measured by non-contact tonometer, ultrasound pachymetry and computer refractor. Various measurements were compared and analyzed statistically.RESULTS: There was a positive correlation between IOP and CCT in patients with refractive errors（ r=0.568,0.534, 0.413, 0.412；P<0.001）. There was no statistically significant correlation between refraction dioptres and CCT, IOP, corneal curvature in refractive errors（r=-0.078,0.068,-0.077; P=0.052, 0.073, 0.058）. There was no statistically significant correlation between corneal curvature, IOP and CCT in refractive error（r=0.004,-0.058; P=0.917, 0.157）.CONCLUSION: There is a positive correlation between IOP and CCT in patients with refractive errors.

Abstract:AIM:To discuss the clinical manifestation of double depressor paralysis(DDP) and evaluate its surgical method and therapeutic effect.METHODS: Six cases of DDP were retrospectively reviewed from July 2009 to September 2011．To examine the eye position, eye movement, compensatory head posture and forced duction test. All patients were operated on the paretic eye. The superior rectus muscle (SR) was weakened and inferior oblique muscle (IO) transferred. The horizontal muscles operation can be executed at the same time or the next time. Clinical characteristics and surgical procedure and the results were summarized.RESULTS: The clinical characteristics of patients were hypertropia of the peratic eye (≥25△). Significant limitation of lateral-in-fraduction and medial-infraduction was observed. Horizontal deviation can be accompanied. The non-paretic eye is often the fixation eye. Some patients show pseudo-blepharoptosis in the primary position when fixed with the paretic eye. After 6 to 24 months follow-up, 5 patients were cured in one operation and the rest one was greatly improved by the second operation.CONCLUSION: Ocular movement examination is efficient and direct method for DDP diagnosis. The operation project lies on the deviation degree and result of forced duction test. Most patients with DDP gain good results. The operation principles include SR slack, IO transfer, accompanied or unaccompanied with horizontal muscles operation.

Abstract:AIM:To compare the effects of two fixedesotropia operation method.METHODS:Retrospectively analyzed the operation courses of 26 cases(45 eyes) with fixed esotropia in the last 11 years. During January 2000 to December 2006, surgeries were done for 17 eyes to cut off tendon of medial rectus and shorten lateral rectus for an excessive amount (Surgery I). During January 2007 to December 2010, surgeries were taken for 28 eyes to cut off tendon of medial rectus, overlap lateral rectus and fix it to orbital periosteum on the side of temporal bone (Surgery II). RESULTS:Among the 17 eyes on which Surgery I was performed, it was found that 4 eyes turned inward for more than 15 degrees 1 day after the surgery. Then surgeries were taken immediately to fix lateral rectus on orbital periosteum so that the eyes could be over corrected for 5-10 degrees. During follow-up about 1 year after surgery, the eyes were over corrected for about 5-10 degrees. During follow-up of the other 13 eyes in 6-18 months after surgery, esotropia of 10-30 degree occurred on 7 eyes. Surgeries were practiced in all of them to fix lateral rectus on orbital periosteum and over correct the eyes for 5-10 degrees. During their visits in 1 year after surgery, the eyes were over corrected for about 5 degrees. Of the 28 eyes on which Surgery II were performed, it was found that all of the eyes were over corrected, and were similar to the surgical designs. During their visits in 1-2 years after surgery, the eyes were over corrected for about 5 degrees. Patients of 2 cases visited us for 3-4 years, and their eyes were slightly over corrected for within 5 degrees.CONCLUSION:Regular surgical treatment for fixed esotropia could not achieve better effect, and the surgical effect will regress in time. The surgery to cut off tendon of medial rectus and shorten lateral rectus for an excessive amount has achieved better effect. It is safer and less difficult. The rate of success is high. And, the rate of regression is low according to statistics of patient visits after the surgery for a long time. It is the one that should be applied in wider scope. 

Abstract:AIM:To investigate the prevalence and correlative factors of diabetic retinopathy (DR) in residents with diabetes mellitus(DM) in Mianyang. METHODS: Totally 749 cases with confirmed DM were enrolled. The data of disease history was collected by inquiry and examination. Examination of ocular fundus and/or fundus fluorescein angiography(FFA) were used to confirm the diagnosis of DR. Fasting sugar, glycosylated hemoglobin and serum level of adiponcetin were examined. RESULTS: Totally 151（20.2%）residents were identified with DR. The incidence of single and proliferative DR was 71.5%(108 cases) and 28.5%(43 cases), respectively. Fasting sugar was 7.86±0.93mmol/L, 8.24±2.17mmol/L, 8.35±3.89mmol/L in DM, single DR and proliferative DR residents, there were no statistical difference（P＞0.05）. Glycosylated hemoglobin and serum level of adiponectin were 6.24%±1.34%, 7.12%±1.51%, 7.94%±1.75% and 848±289mg/L,6.74±2.11mg/L,4.57±1.82mg/L respectively in residents with DM, single DR and proliferative DR, there were statistical difference of glycosylated hemoglobin and serum adiponectin level among three groups. CONCLUSION: The incidence of DR is high in residents with DM. High glycosylated hemoglobin and serum level of adiponcetin of DM patients should be closely monitored in order to control DR.

Abstract:By describing the experience of making and applying computing aided instruction (CAI) courseware for teaching glaucoma, the authors emphasize the importance of applying modern multimedia courseware in medical teaching program. CAI courseware fully reflects the advantages of modern multimedia courseware in medical education.

Abstract:AIM:To know the prevalence, high risk factors of diabetic retinopathy(DR) to provide evidence to the prevention and treatment of DR.METHODS:The investigation based on the demographic features and the distribution of Hui and Han nationalities using cluster random sampling, finishing the last sampling, ensuring the sample size of community and villages and filling the questionnaire of DR prevalence. Analyze the prevalence and high risk factors of DR in Ningxia region.RESULTS:Among 3001 cases, 76 cases were diagnosed with diabetes, in which 13 cases were DR, accounted for 17.11％ in diabetes, 0.43% in all subjects. There were males 5 cases, females 8 cases, no significant difference between prevalence of male and female, no significant difference of male prevalence between urban and rural district, as well as female. Eight cases with DR were found in 1734 Han cases, the prevalence rate was 0.46%; 4 cases with DR were found in 1240 Hui cases, the prevalence rate was 0.32%; there was significant difference between Han and Hui cases. The diabetic course, blood pressure, blood lipid and related factors of glucose control situation were analyzed. In those diagnosed DR cases, diabetic course＜5a was 1 case(7.69％), 5-10a 4 cases(30.77％), ＞10a 8 cases(61.54％).Ten cases (76.92％)were combined with hypertension, 8 cases combined with hyperlipidemia(61.54％).CONCLUSION:The prevalence of DR in Ningxia region was 17.11％, accounted for 0.43% in all subjects(the crowd rate ). The prevalence between male and female had no significant difference, the female DR patients in urban district was higher than that in rural district. The prevalence of DR in urban district was higher than that in rural district, there was significant difference. The prevalence of DR in Han nationality was higher than that in Hui nationality, there was significant difference. Long-term of diabetes, higher fasting plasma glucose (FPG), combined hypertension and hyperlipidemia are high risk factors to DR. Regular fundus examination and test of high risk factors for high risk diabetic patients are the key to prevent and treat DR.

Abstract:AIM： To observe the effect of manual chopping nucleus technique in phacoemulsification cataract surgery.METHODS: The manual chopping nucleus technique was performed in 132 cases (179 eyes) of age-related cataract with hard nucleus gradedⅢ,Ⅳ and Ⅴ before phacoemulsification. Male were 56 cases (82 eyes), female were 76 cases (97 eyes), the age was 53-74 (average 67.7±6.4) years. Subjects with lens dislocation, glaucoma and uveitis were exclused. Intraoperative phaco power and time, postoperative visual acuity and corneal edema were observed, and the follow-up were carried out for 1 week. RESULTS: Manual chopping nucleus technique before phacoemulsification reduced the release of ultrasound power. The low incidence of corneal edema was found postoperatively. CONCLUSION:Manual chopping nucleus technique was safe and effective in phacoemulsification cataract surgery.

Abstract:AIM: To observe the therapeutic effect of phacoemulsification combined with vitrectomy for the treatment of high myopia complicated with cataract. METHODS: Vitrectomy combined with phacoemulsification were performed in 15 cases (18 eyes) with high myopia complicated cataract, postoperative visual acuity and complications were analyzed.RESULTS: During the postoperative follow-up, visual acuity was improved in all 18 eyes, and no related complications occurred. CONCLUSION: Phacoemulsification combined with vitrectomy decrease the risk of postoperative retinal detachment in the treatment of high myopia complicated with cataract.

Abstract:AIM: To investigate effect between compound and traditional trabeculectomy for the treatment of glaucoma with persistent high intraocular pressure. METHODS: Retrospectively analyzed 103 glaucoma cases (103 eyes) with persistent high intraocular pressure in our hospital from 2006/2009. All cases were divided into group A and group B. Fifty-nine eyes in group A underwent compound trabeculectomy. Forty-four eyes in group B underwent traditional trabeculectomy. The postoperative incidence of depth of anterior chamber, postoperative IOP, filtration blebs and complications were followed up and compared and statistically analyzed. RESULTS: The operation was successful in all the cases. No perichoroidal space bleeding or vitreous prolapse occurred. During the follow-up of 6-24 months, the IOP was 10-21mmHg in 49 eyes in group A and 31 eyes in group B. There was significant difference between group A(83.1%,49 eyes)and group B (70.5%, 31 eyes) by SPSS 17.0(P=0.002<0.05). CONCLUSION: The compound trabeculectomy is applicable to many types glaucoma with less complications and high successful rate.

Abstract:AIM:To study the application of amniotic membrane transplantation combined with adjustable sutures in trabeculectomy. METHODS:In our hospital from January 2009 to June 2010, 50 cases(54 eyes) with acute angle-closure glaucoma after trabeculectomy were included. After conventional trabeculectomy, a 6mm×7mm amniotic membrane was placed under scleral flap on the scleral bed, scleral flap corners were fixed 2 needles. One or two sides of the scleral flap was fixed with 1or 2 adjustable sutures, knotting in the transparent cornea. BSS formed the anterior chamber. The follow-up was 1.5 years. RESULTS:The postoperative intraocular pressure was well controlled, with a success rate of 89%, conditional successful rate of 7%, failed 4%. CONCLUSION:Amniotic membrane transplantation combined with adjustable suture is a safe, effective method in treatment of acute angle-closure glaucoma.

Abstract:AIM:To evaluate the effect of phacoemulsification combined with goniosynechialysis for the treatment of primary angle-closure glaucoma(PACG) complicated with cataract.METHODS:Totally 45 cases (52 eyes) who were PACG complicated with cataract underwent transparent corneal incision cataract phacoemulsification and goniosynechialysis by topical anesthesia.RESULTS:Visual acuity improved significantly, central anterior chamber depth and angle all improved differently after operation.CONCLUSION:It is an effective and safe therapy for PACG complicated with cataract treated by phacoemulsification combined with goniosynechialysis.

Abstract:AIM:To evaluate the effects ofpars plana vitrectomy(PPV) combined with internal limiting membrane peeling for the treatment of macular edema secondary to retinal vein occlusion (RVO).METHODS:Twelve cases of visual loss due to macular edema caused by central RVO or branch RVO underwentPPV combined with internal limiting membrane peeling. Best-corrected visual acuity (BCVA) and central foveal thickness by optical coherence tomography(OCT) were measured pre- and postoperatively then compared to assess the outcome of surgery.RESULTS:In all cases retinalthickeness diminished within 2 months of surgery. Visual acuity improved in all of the central RVO cases and 4 out of 8 branch RVO cases. The decrease in macular thickness was statistically significant (mean postoperative macular thickness 361±61.1μm versus mean preoperative macular thickness 563.9±90.0μm, P=0.001, t-test). The improvement in BCVA was not statistically significant (mean preoperative BCVA in LogMAR 1.23±0.29 versus mean postoperative BCVA in LogMAR 1.06±0.49, P=0.09, t-test).CONCLUSION: In eyes with macular edema secondary to RVO,PPV combined with internal limiting membrane peeling can resolve macular edema, but the improvement in BCVA was not statistically significant in this study.

Abstract:AIM:To summarize the clinical experience on inverse planting silicone tube with spherical end for treatment effects for chronic dacryoadenitis． METHODS:Sixty-five cases(70 eyes)of chronic dacryocystitis patients were involved and underwent inverse planting silicone tube with spherical end under local anesthesia, then after the surgery they all were received anti-infective treatment. Irrigation of lacrimal passage were performed every day for the first three days, once a week for 4 times, then once a month for 5 times. RESULTS:All the patients were successfully implanted with silicone tube with spherical end. No secretion was found bylacrimal passages irrigating during 16 months observation period. 64 eyes (91.43%) were cured completely, 6 eyes (8.57%) were improved significantly. CONCLUSION:The treatment for chronic dacryocystitis by inversely planting silicone tube with spherical end is a perfect method. It is simple, safe, timesaving, less bleeding without incision, scar and has high successful rate. So this operation is worth being spread widely.

Abstract:AIM:To evaluate the influence of wearing soft contact lens(SCL) on central corneal thickness(CCT) and curvature.METHODS：The CCT and corneal topography of 143 cases (286 eyes) who were wearing SCL were measured with ultrasonic pachymeter. 154 normal subjects were selected as control. The difference of CCT and corneal curvature among normal subjects and subjects wearing SCL in different duration were analyzed.RESULTS：There was no statistically significant difference in CCT between short-term wearing patients(≤2 years) and the control. CCT of long-term wearing patients(>2 years) was significantly thinner than CCT of the control and the patients worn SCL short term(<2 years) (P<0.05). There was no significant difference among all groups in corneal curvature(P<0.05).CONCLUSION: CCT did not change in short term wearing eyes. However, CCT decreased gradually with time passing in long term of contact lens wear. There was no relation between corneal curvature and the time of contact lens wear. Corneal unregularity was inclined to increase with long-term wear of contact lenses.

Abstract:AIM:In order to assess the characteristics of severe systemic diseases in ophthalmologic inpatients in our hospital, and to improve the prevention, diagnosis, and treatment of these diseases in earlier stages.METHODS:The medical records of inpatients with systemic diseases from 2016 cases in Xi' an Northern Hospital from June 2007 to December 2010 were retrospectively analyzed, which included new acute diseases and chronic diseases with acute occurrence.RESULTS:In all the 2016 inpatients, 1644 patients (81.55%) with a history of systemic disease, 36 patients (1.79%) developed severe systemic disease in hospital. The severe systemic diseases included 19 hypertensive crisis, 3 myocardial infarction, and 2 acute hypotension in circulatory system; 2 hematencephalon and 2 acute cerebral infarction in nervous system; 2 acute gastroenteritis and 1 acute gastrointestinal blooding in digestive system; 2 acute abdomen induced by lithangiuria in urinary system; and 3 severe drug allergy. After appropriate rescue, all of the inpatients with severe systemic disease were got in good conditions, without progress of their ocular diseases.CONCLUSION:With majority of senile and a history of systemic diseases, the risk of severe disease is higher in ophthalmologic inpatients. It is helpful for ophthalmologic treatment with a comprehensive evaluation, diagnosis, and effective treatment of severe systemic diseases in early stages. 